Intestinal Ultrasound for Monitoring Postoperative Crohn's Disease: A Review and Visual Atlas

Despite advances in therapeutic strategies, postoperative recurrence (POR) of Crohn's disease (CD) remains common, underscoring the importance of vigilant and accurate surveillance. Colonoscopy is the gold standard to assess for POR, but it is invasive and can be poorly tolerated by patients. Intestinal ultrasound (IUS) has emerged as a reliable, noninvasive modality for monitoring CD at the point of care and has excellent accuracy for evaluation of POR. However, visualization of the ileocolic anastomosis with IUS can be challenging. This review provides practical guidance for identifying the ileocolic anastomosis and its key sonographic landmarks. It also outlines techniques for assessing the anastomosis with grayscale IUS and discusses strategies for integrating IUS into routine postoperative surveillance of CD.